title: Risk factors for coronary heart disease in a population with a high prevalence of obesity and diabetes: a case-control study of the Polynesian population of Western Samoa.
abstract: OBJECTIVE
  To evaluate anthropometric, haemodynamic and biochemical risk markers for coronary heart disease (CHD) in the Polynesian population of Western Samoa in a case-control study of 43 cases of CHD compared with 90 age- (mean 53 years) and sex-matched controls.
  
  
  METHODS
  Cases were identified on the basis of a 12-lead electrocardiogram and clinical history.
  
  
  RESULTS
  More than 60% of the participants had a body mass index > or =30 kg/m2 and nearly 80% had central obesity. Both diabetes mellitus (17%) and impaired glucose tolerance (9%) were also common in this population. Nineteen per cent of the population were hypertensive and both antihypertensive therapy (21 versus 1%, P<0.001, risk 23.6) and hypertension (35 versus 11%, P<0.01, risk 4.3) were significantly more common among cases than they were among controls. In addition, the plasma high-density lipoprotein cholesterol level was lower (1.00+/-0.09 versus 1.24+/-0.05 mmol/l, P<0.05) and the plasma urate level was higher (0.42+/-0.02 versus 0.37+/-0.01 mmol/l, P<0.05) in the female cases than they were in their respective controls. Low-density lipoprotein (LDL) particle sizing did not reveal an excess of small LDL particles to be a feature of CHD cases, but more than 70% both of cases and of controls had multiple LDL species. The response of the triglyceride level to a fat-rich meal was the same for CHD cases and controls.
  
  
  CONCLUSIONS
  The population studied had a high prevalence of several risk factors for CHD, including obesity and non-insulin-dependent diabetes mellitus; however, the most prominent factor relating to CHD within the community was the presence of hypertension.
authors.affiliation: Baker Medical Research Institute, Melbourne, Victoria, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Wahi
authors.forename: C D
authors.initials: CD
authors.lastname: Gatzka
authors.forename: B
authors.initials: B
authors.lastname: Sherrard
authors.forename: H
authors.initials: H
authors.lastname: Simpson
authors.forename: V
authors.initials: V
authors.lastname: Collins
authors.forename: G
authors.initials: G
authors.lastname: Dowse
authors.forename: P
authors.initials: P
authors.lastname: Zimmet
authors.forename: G
authors.initials: G
authors.lastname: Jennings
authors.forename: A M
authors.initials: AM
authors.lastname: Dart
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D003327:Coronary Disease / Q000208:ethnology* / Q000209:etiology; D003625:Data Collection; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000208:ethnology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D014905:Independent State of Samoa / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000208:ethnology*; D011114:Polynesia / Q000208:ethnology; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution